Corticosteroids for preventing graft-versus-host disease after allogeneic myeloablative stem cell transplantation

The administration of corticosteroids to the prophylaxis regimen of graft-versus-host disease (GvHD) after allogeneic myeloablative stem cell transplantation reduces the incidence of milder forms of acute GvHD, but there is no evidence that this is of any benefit regarding survival of the patients.

A Cochrane review included 5 studies with a total of 604 subjects. The pooled results revealed that the addition of corticosteroids reduces statistically significant the risk for acute GvHD grade I to IV (HR 0.58; 95% CI 0.45 to 0.76) and II to IV (HR 0.69; 95% CI 0.51 to 0.92). No evidence was found that it has any clinical relevance on overall survival (HR 0.99; 95% CI 0.79 to 1.25) or disease-free survival (HR 0.95; 95% CI 0.74 to 1.23). As well, no statistically significant influence was found for acute GvHD grade III to IV (HR 0.78; 95% CI 0.52 to 1.15), chronic GvHD (HR 1.21; 95% CI 0.89 to 1.65), relapse incidence (HR 0.82; 95% CI 0.57 to 1.18) or non-relapse mortality (HR 0.88; 95% CI 0.61 to 1.26). No clear evidence was found that the rate of infectious complications (under the concomitant use of antiviral or antibacterial medication or both) increases with the addition of corticosteroids.

Ədəbiyyat

1. Quellmann S, Schwarzer G, Hübel K, Greb A, Engert A, Bohlius J. Corticosteroids for preventing graft-versus-host disease after allogeneic myeloablative stem cell transplantation. Cochrane Database Syst Rev. 2008;(3):CD004885.